According to the American Medical Association, administrative costs associated with the processing of health care insurance claims is upwards of $210 billion per year in the United States. The AMA also estimates that as many as 1 in 5 claims is processed inaccurately leading to significant amounts of money lost due to waste, fraud, and abuse. Three major reasons that claims are not processed by payers are:                Procedures are charged for a dollar amount greater than the payer's allowed amount for that procedure        The diagnosis codes (ICD9/10) are not sufficient to warrant the procedure.        The combination of procedures in the claim is not valid, i.e. having 2 diagnostic tests that overlap.        
Clinicians are increasingly adopting electronic clinical decision support tools to aid in determining their diagnoses. However, no system exists that provides healthcare provider billing personnel with the ability to discover abnormal claims and provide details on which constituent parts may need to be addressed so that the claim is adjudicated as desired.